February 2, 2010

Bitter Sweet or Toxic?

Indigenous people, diabetes and the burden of pollution

[cc 2.0]There may be more to diabetes than our diet, or whether or not we get enough exercise. According to several new studies, it may be the result of our exposure to Persistent Organic Pollutants. Photo: Leah Ciboulette

WINNIPEG—Diabetes is now widely regarded as the 21st century epidemic. With some 284 million people currently diagnosed with the disease, it’s certainly no exaggeration—least of all for Indigenous people.

According to the State of the World's Indigenous Peoples Report by the United Nations, more than 50 per cent of Indigenous adults over the age of 35 have Type 2 Diabetes, “and these numbers are predicted to rise.”

Diabetes is referred to as a "lifestyle disease," its rampant spread believed to be caused by obesity due to our increased reliance on the western diet (also known as the "meat-sweet" diet) and our avoidance of regular exercise.

While these may certainly be contributing factors, there is growing evidence that diabetes is closely linked with our environment. More than a dozen studies have been published that show a connection between Persistent Organic Pollutants (POPs) including polychlorinated biphenyls (PCBs); carcinogenic hydrocarbons known as Dioxins; and the "violently deadly" synthetic pesticide, DDT and higher rates of the disease.

“If it is the POPs, not the obesity that causes diabetes, this is really striking if true,” says Dr. David O. Carpenter, director of the Institute for Health and the Environment at the University of Albany.

One out of four Indigenous adults living on reserves in Canada have been diagnosed with Type 2 Diabetes, the most common form of diabetes. The prevalence of the disease appears to be so great that the number of new cases being diagnosed in Canada may exceed the growth of the Indigenous population. It’s no longer uncommon to find children as young as three with the disease. According to government statistics, 27 per cent of all Indigenous people in Canada will have Type 2 Diabetes in the next ten years.

Sandy Lake First Nation, in the Sioux Lookout Zone of northern Ontario, has all but met the mark. A March 2009 study co-authored by Dr. Stewart Harris found that 26 per cent of the community has the disease, the highest recorded rate of diabetes in Canada. With a population of 2,500, the northern Cree community was recently described as an “epicentre” of the epidemic.

There has been little research on the levels of persistent organic pollutants in Sandy Lake; however, according to the First Nations Environmental Health Innovation Network, several neighboring communities who also have high rates of diabetes, like Kitchenuhmaykoosib Inninuwug First Nation, are known to have elevated levels of PCBs in their blood.

The Mohawk community of Akwesasne has its own conflict with diabetes and exposure to POPs. Located across the New York-Ontario-Quebec borders along the St. Lawrence River, three aluminum foundries upriver from the reserve dumped PCBs into the river for decades, contaminating the water, soil, and vegetation.

For many years, Dr. Carpenter has been involved in the study of Adult Mohawks at Akwesasne. Most recently, in 2007, he took part in a study to examine the diabetes/pollution link in the community. “Our study of adult Mohawks showed a striking elevation in rates of diabetes in relation to blood levels of three persistent organic pollutants, DDE, the metabolite of DDT, hexachlorobenzene and PCBs,” Dr. Carpenter explains. “Our results are quite compatible with those of Lee et al.”

In 2006, Dr. Dae-Hee Lee and her colleagues showed that people with the highest rate of exposure to POPs were roughly 38 times more likely to have diabetes than those with the lowest rate of exposure. Further, “they showed that people who were obese but did not have high levels of POPs were not at increased risk of developing diabetes,” continues Dr. Carpenter. “Probably the reason most people get obese is that they eat too many animal fats, and this is where the POPs are.”

The dietary source of POPs was confirmed by the US Environmental Protection Agency in their Draft 1994 Dioxin Reassessment, which has never been formally released to the public. According to the Draft Reassessment, 93 per cent of our exposure to Dioxin comes from the consumption of beef, dairy, milk, chicken, pork, fish, and eggs; in other words, the western diet.

A May 2001 study published in the Journal of Toxicology and Environmental Health drew similar conclusions to the EPA Reassessment. In addition, the study found that “nursing infants have a far higher intake of dioxins relative to body weight than do all older age groups,” and that human breast milk was twice as toxic as dairy milk. It also found that vegans had the overall lowest rate of POPs in their bodies.

According to an October 2009 paper by the Research Centre for Environmental Chemistry and Ecotoxicology at Masaryk University, another major source of POPs, specifically DDT, is the world’s oceans. The paper also found that despite restrictions placed on the use of DDT more than 30 years ago, concentrations of the toxin are on the rise.

Indigenous people carry an unequally high proportion of this global toxic burden. For instance, according to Environment Canada’s National Pollutant Release Inventory (NPRI) there are 212 Indigenous communities in Canada living near or downstream from pulp mills and other facilities that produce dioxins and furans. One striking example is the old Dryden pulp mill near Grassy Narrows which, according to the Grassy Narrows and Islington Bands Mercury Disability Board, dumped tonnes of dioxin-laced mercury wastewater into the English-Wabigoon River system from 1962-70.

Forty years later, the poisonous waste continues to pose a “serious health threat” to Grassy Narrows and the Wabaseemoong First Nations, says the Disability Board. No formal steps have been taken toward remediation by federal or provincial governments.

The Tohono O’odham Nation's experience bears a close resemblance to Grassy Narrows: the world’s highest rate of diabetes can be found in southwest Arizona nation. According to Tribal health officials, nearly 70 per cent of the population of 28,000 has been diagnosed with the illness. The O’odham People make up the second largest Indigenous Nation in the United States.

Lori Riddle is a member of Aquimel O’odham Community and founder of the Gila River Alliance for a Clean Environment (GRACE).

GRACE was instrumental in the 10 year struggle against a hazardous waste recycling plant that operated without full permits on O’odham land for decades. Owned by Romic Environmental Technologies Corporation, the plant continuously spewed effluents into the air until it was finally shut down in 2007.

The Romic plant was not the first contributor to the O’odham’s toxic burden, explained Riddle. Looking back to her childhood, she recalled: “For nearly a year, [when] a plane would go over our heads, you could see the mist. We never thought to cover our water. The chemicals just took over and they became a part of us.”

From the early 1950s until the late 60s, cotton farmers in the Gila River watershed routinely sprayed DDT onto their crops to protect them from bollworms. According to the Agency of Toxic Substances and Disease Registry (ATSDR), each and every year the farmers used roughly twenty-three pounds of DDT per acre.

In 1969, the State of Arizona banned the use of DDT; by this time the river was gravely contaminated. According to the ATSDR, farmers then switched to Toxaphene, a substitute for DDT—until it was banned by the US government in 1990.

Because of these chemicals, Riddle explains, the O’odham were forced to abandon their traditional foods and adopt a western diet. Farms also went into a recession, forcing many families to leave their communities. Companies, such as Romic, began moving on to their territory, exasperating the situation. “It’s taken a toll on our quality of life,” she says. “I’ve cried myself to sleep.”

The O’odham are dealing with what Riddle terms “cluster symptoms,” including miscarriages, arthritis in the spine, breathing problems, unexplainable skin rashes and problems regenerating blood cells. This is in addition to diabetes, which frequently leads to renal failure, blindness, heart disease, and amputations.

More and more studies are showing the link between diabetes and persistent organic pollutants like DDT—stemming from the landmark Ranch Hand study. In 1998, the study found a 166 per cent increase in diabetes (requiring insulin control) in US Air Force personnel who were sprayed with the herbicide and defoliant Agent Orange during the Vietnam War. The study also found that as dioxin levels increased so did the presence and severity of Type 2 Diabetes, and the time to onset declined following a similar trend.

However, Dr. Carpenter notes that because of the widely-endorsed belief that diabetes is a life-style disease related to diet and exercise, the link is gaining little attention by governments, news agencies, or by any of the hundreds of non-profit diabetes foundations around the world. “[It] hasn’t even made it into the medical community at this point,” Dr. Carpenter adds. “It takes a long time to change both medical and public opinion.”

“Clearly one thing everyone can do is to eat less animal fats,” suggests Dr. Carpenter. Several Indigenous communities in northern Manitoba and British Columbia have begun to do this, planting their own gardens and building greenhouses; returning, in a traditional sense, to some of the foods that sustained them for millennia. Others are turning to exercise, which plays a vital role not just in the prevention of diabetes, but in their overall health.

"Also, we must find ways of getting the POPs out of the animals that we eat. That is not going to be easy, given how contaminated we have made the world,” adds Dr. Carpenter. For this, Lori Riddle, who is herself a diabetic, points to the Tribal Council and the Federal Government.

Exposure to dioxins is linked to insulin resistance, which causes diabetes, according to research published this month in Epidemiology.1 Experts say that there is now strong evidence for a link between diabetes and exposure to persistent organic pollutants (POPs), including dioxins, but that this is still being largely overlooked by the medical community.

“There’s just been a flood of evidence linking POPs to diabetics in the last five years,” says David Carpenter, Director of the Institute for Health and the Environment at the University at Albany, New York, USA. “When you put this study in the context of what’s being done in other groups, it gives a very convincing story.”

The researchers, led by Jung-Wei Chang of the National Cheng Kung University in Tainan, Taiwan, measured the levels of serum dioxins, fasting glucose, and insulin in 1234 people living near an abandoned pentachlorophenol manufacturing plant. They used a homeostasis model, which uses fasting glucose and insulin levels to estimate insulin resistance. After controlling for risk factors such as age, obesity, and family history of diabetes, they found a positive association, with a linear dose-response, between serum dioxins and the prevalence of insulin resistance.

Earlier studies have linked a variety of POPs, including dioxins, polychlorinated biphenols (PCBs) and organochlorine pesticides such as DDT, to an increased risk of type II diabetes. Since obesity is linked with greater levels of POPs in the body, scientists speculate that the link between obesity and the development of diabetes might be mediated through these toxins.

“People get obese because they eat too much animal fat, and that’s where the contaminants are,” Carpenter points out. This effect may explain why indigenous populations in Canada are at higher risk of diabetes, Carpenter explains, as they are often exposed to greater levels of POPs than the general population.

One study in particular,2 led by Duk-Hee Lee of the Kyungpook National University in Daegu, Korea, looked at 2016 participants to the 1999–2002 National Health and Nutrition Examination Survey, which took blood samples from a cross section of the general US population, and found no association between obesity and diabetes among people with no detectable levels of POPs in their blood. This implies that the risk of diabetes from obesity could be largely due to POPs, which accumulate in adipose tissue, rather than physiological changes that come with obesity, Carpenter says.

“I am somewhat sceptical of that finding,” says David Jacobs, Professor of Public Health at the University of Minnesota and one of Lee’s co-authors. The association between exposure to POPs and diabetes is stronger in obese people, he points out. But it’s clear that POPs and obesity interact to raise the risk of diabetes, he says.

This would suggest that losing weight may only partially reduce the risk for diabetes. POPs accumulate in adipose tissue — which means that weight loss releases the toxins back into the blood. “That stuff has got to go somewhere,” Jacobs says. “It’s clear that POPs [released from fat deposits] distribute into blood and other tissues.”

Worryingly, some data show a stronger association with diabetes at low concentrations of POPs, Jacobs says. “We have seen that kind of pattern, but it’s very difficult to interpret,” says Jacobs. Because of the difficulty of measuring low-level exposure to these pollutants, a lot more research is needed to confirm whether they have this effect, he argues.

Despite the body of evidence linking POPs and diabetes, the link is still not widely acknowledged in the medical community. “Physicians are totally oblivious to this being a risk factor,” Carpenter says. “The nutrition community have oversold the benefits of fish and underplayed the dangers of contaminants.”

Although production of many of the toxins studied has been banned worldwide, they persist in the environment, are distributed globally, and continue to bioaccumulate in the food chain. Pesticides like DDT, which are still used in malarial regions, can turn up in the food supply all over the world. And others are still on the increase. “[POP] exposure is to some degree going down, except in the case of flame retardants where exposure is increasing exponentially,” Carpenter says. Flame retardants are structurally very similar to PCBs, he points out, and so these too should be investigated for the potential to cause diabetes — especially as children are among the most highly exposed population groups.

Abstract
Background: Several epidemiologic studies suggest a slightly increased risk of type 2 diabetes in relation to background levels of dioxins. Little is known about how serum dioxins might affect insulin resistance, a hallmark of type 2 diabetes. We examined the association between exposure to dioxins and insulin resistance.

The pollution/diabetes connection has received no major news coverage anywhere in the world. I hope you will share the media release below with all your media contacts. Also, please share this information with all your scientific, environmental and Tribal colleagues who are studying diabetes. Much is at stake for the health of people all over the world. All the very best to you.

Health Canada Predicts that within 10 years, 27% of all First Nations people in Canada will have Type II Diabetes. Many First Nations People have been exposed to toxins such as DDT, Dioxin, Arsenic, Cadmium Hexachlorobenzene and PCB's for many decades.

For a Summary of the latest Scientific research on this topic, please go to:

http://www.ajmed.fr/documents/pdf/perturbateurs_diabete.pdf

For some of the very latest studies on pollution/diabetes links please go to:

Key Scientific Contacts Re: Diabetes and Pollution
(Please Note, above are links to many of these scientists most recently published and peer reviewed studies on the pollution/diabetes connections):

1) Dr. David Carpenter carpent@uamail.albany.edu United States

2) Dr. Duk-Hee Lee lee_dh@knu.ac.kr Korea

3) Dr. Joel Michalek michalekj@uthscsa.edu United States

4) Dr. Mary Turyk mturyk1@uic.edu United States

5) Dr. Miquel Porta mporta@imim.es Spain

6) Dr. Lars Rylander lars.rylander@med.lu.se Sweden

7) Dr. Anna Rignell-Hydbom anna.rignell-hydbom@med.lu.se Sweden

8) Dr. Laurie Chan lchan@unbc.ca Canada

9) Dr. Harold Schwartz harold_schwartz@hc-sc.gc.ca Canada

First Nations Pollution/Health Contacts:

Research Tools and Contacts for the Communities Re: Pollution and Health

Dear Friends,

Many communities are experiencing health problems related to exposure to industrial pollutants. Many people want to investigate the pollution/health links in their community but have little funding and aren't sure where to begin. To assist people in their pollution/health research, here are a few inexpensive community action tools to get started and some key contacts to compare notes with and get advice from. Hope this information is helpful to protect the health and well being of your community. Also, here are the tools to start a broad based coalition to eliminate pollution and protect the health of the people and the earth. All the best to you all.

For Land and life,
Your Friend,
John H.W. Hummel
Nelson, B.C.

'Bucket Brigade' :An Inexpensive Way to Find Out What Pollution is in Your Communities Air: http://www.bucketbrigade.net/article.php?list=type&type=9

James Brophy, Scientist and expert in Worker Health and safety: jimbrophy@sympatico.ca

Dear Friends,

Here are a few key contacts for you if you wish to investigate the health impacts of industrial pollution on First Nations, Metis and Inuit people in North America in 2009.

1) Dr. David Carpenter,Toxicologist, University of Albany, NY: carpent@uamail.albany.edu
- David has been doing toxics research with the Mohawks of Akwesasne for many years and recently published scientific papers showing a dramatic increase in Diabetes and Heart Disease in
Akwesasne Mohawks with PCB's and Pesticides in their blood

2) Henry Lickers, Akwesasne Mohawk Nation, Cornwall, Ontario: hlickers@akwesasne.ca
- Henry has worked at the Akwesasne Environment department for decades and can describe the impacts of PCB's, mercury, pesticides, fluoride etc on his people

3) Ken Jock, Akwesasne Mohawk Nation, Cornwall, Ontario : ken_jock@srmtenv.org
- Ken works on environmental issues at Akwesasne and can describe the health impacts pollution has had on his people

4) Joyce King, Haudenosaune Environmental Task Force: joyceking@westelcom.com
- Joyce can describe pollution/health impacts on the Six Nations people as a whole

9) James Brophy, Research Scientist: jimbrophy@sympatico.ca
- James Co-Authored Pollution/Health papers with Michael Gilbertson and is presently helping Aamjiwnaang First Nation expose pollution related health problems in their community

10) Ron Plain, Aamjiwnaang First Nation, Sarnia, Ontario: rplain@environmentaldefence.ca
- Ron is a Pollution/Health Activist at Aamjiwnaang and works at Environmental Defence Canada to expose pollution/health issues in Aboriginal Communities

12) Wilson Plain, Aamjiwnaang First Nation, Sarnia, Ontario: wilsonplain2@hotmail.com
-Wilson is part of the Aamjiwnaang Environment Committee and was recently found to have PCB's and all kinds of other industrial toxins in his body

13) Judy DaSilva, Grassy Narrows First Nation, Ontario: jsilva@northone.ca
-Judy is a Clan Mother, Healer, environmental activist and spokesperson at Grassy Narrows and can tell you about the mercury poisoning in her community, the dioxins and furans found in Grassy's wild meat and the herbicide spraying of Grassy's traditional territory

14) Steve Fobister Sr., Grassy Narrows First Nation, Ontario: gsfobister@hotmail.com
- Steve is a Councillor at Grassy Narrows First Nation and has been a leader of his people for decades.
Steve can tell you about what has happened at Grassy from all the pulp-mill pollution and herbicide spraying.
My pal Steve, his daughter and his little Granddaughter and many of his other family members all have Mercury Poisoning from that Pulp Mill at Dryden

15) Joe B. Fobister, Grassy Narrows First Nation, Ontario: jbfobister@yahoo.ca
- Joe is a spokesperson for the Grassy Blockaders and a leader of his community. He can tell you all about what the pollution has done to the health of his people

16) Sherry Fobister, Grassy Narrows First Nation, Ontario: namesfobister@hotmail.com
-Sherry is another dear friend. She is a great spokesperson and can tell you firsthand about the difficulties she has faced as a single Mum dealing with her own mercury related health problems as well as that of her little daughter Catherine

17) Emily Fobister, Grassy Narrows First Nation,Ontario: mommie52006@hotmail.com
- Emily did a Sacred walk to help her people heal from all the industrial sicknesses harming her family and people. She inspired many youth and helped many people.

18) Dr. Masazumi Harada, Mercury Expert in Japan: mharada@kumagaku.ac.jp
- Dr. Harada discovered mercury poisoning at Grassy Narrows and Whitedog in the 1970's and found new cases amongst Grassy children when he returned and tested people in 2003.

19) Dr. Leanne Simpson, Expert on First Nations Pollution/Health Issues: leannesimpson@sympatico.ca
- Leanne worked on the Grassy Narrows/Wabauskang wild meat testing study and is presently investigating all the deaths and sickness among Wabauskang people from when they lived at Quibel, Ontario immediately downstream from the Dryden Pulp Mill

20) Betty Riffel, Wabauskang First Nation, Ontario: bet093@hotmail.com
- Betty is working with Leanne Simpson to investigate the deaths of all those infants when her people lived at Quibel. She also worked on the Grassy Narrows/Wabauskang wild meat study where they recently found mercury, furans etc. in the fish and wildmeat eaten by the people

21) Damien Lee, Fort William First Nation, Ontario: connectwithdamien@gmail.com
-Damien heads up the Anishinabek of the Gitchi Gami (AGG) environmental group at Fort William First Nation and is knowledgable about the hundreds of random dumpsites at his community, the pollution from local industry surrounding his community and much more!

22) Wendy Solomon, Fort William First Nation, Ontario: ladysigni_sha@msn.com
- Wendy is the outreach coordinator for AGG and another dedicated environmental/health advocate at Fort William First Nation who knows alot about pollution/health issues

33) Betsy Mandamin, Grand Council Treaty 3, Kenora, Ontario: health@treaty3.ca
- Betsy works at Treaty 3 Health department and has much knowledge of Mercury pollution and environmental/health issues in the whole Treaty 3 Area

34) Dorothy Friday, Grand Council Treaty 3, Kenora, Ontario: health@treaty3.ca
- Dorothy also works at Treaty 3 Health Department and knows alot about pollution/health issues in the Treaty 3 Area

36) Tom Goldtooth, Director, Indigenous Environment Network (IEN): ien@igc.org
- Tom Coordinates the IEN south of the border, a big focus of IEN has been pollution/health issues and he can put you in touch with Aboriginal communities who have health problems due to pollution all over North America and beyond!

38) Allister Marshall, FNEN - East Coast: amarshall@potlotek.ca
-Allister is very knowledgable about pollution/health issues impacting First Nations on the East Coast of Canada

39) Ishbel Munro, FNEN - East Coast: coastalnet@ns.sympatico.ca
-Ishbel has been an advocate for environmental/Aboriginal issues for decades and can put you in touch with pollution impacted First Nations all over (especially in Nova Scotia)

40) Willi Nolan, Elder/Environmental Activist, East Coast: willi@web.ca
- Willi is a respected Anishinawbe Elder who is very knowledgable about pollution/health impacts on First Nations communities. Willi's main focus is to share traditional knowledge of the environment and Mother Earth with the youth. Willi has done truly remarkable things! Someone should write a book about her.

41) Al Hunter, FNEN - Ontario: tbird2@netscape.net
- Al Hunter is a former Chief of his people, a respected Elder (even though he is young) and knows lots about pollution in the Manitou Rapids, Rainy River area of Ontario. He has many contacts knowledgable about pollution/health impacts on Aboriginal communities.

42) Fred Greene, Grand Council Treaty 3, Kenora, Ontario: fred.greene@treaty3.ca
- Fred is a political advisor to the Ogichida of Grand Council Treaty 3 and is very knowledgable about pollution impacts on the Treaty 3 First Nations

43) Alan Penn, Expert on Mercury Poisoning of James Bay Cree: apenn@gc.ca
- Alan is an expert on the Mercury pollution of the James Bay Cree communities

47) Dr. John O'Connor, Former Dr. for Fort Chipewyan People: gramocroi@shaw.ca
- Dr. O'Connor discovered rare cancers in the people of Fort Chipewyan First Nation in Alberta likely due to pollution from Tar sands development. The Government has been hounding him and trying to take away his Physicians lisence ever since he went public with his concerns for Fort Chipewyan people.

48) George Poitras, Health Official, Fort Chipewyan Area: george.poitras@shawbiz.ca
- George is one of the spokespeople for First Nations in Alberta concerned about pollution/health problems associated with Tar sands Development in northern Alberta.

49) Kevin Timoney, Researcher: ktimoney@compusmart.ab.ca
- Kevin did a huge report on pollution from the Tar Sands development which could be harmful to First Nations in the area.

50) Winona LaDuke, Famous First Nations Environmental Activist: honorearth@earthlink.net
-Winona is a very famous Native American environmental activist who can tell you alot about pollutions health impacts on Aboriginal communities all over North America

51) Chief Thomas Alexis, Chief of Tl'azt'en First Nation, B.C.: thomas.alexis@tlazten.bc.ca
- Many of Chief Alexis's people are sick and dying of mercury poisoning from an old mercury mine in northern B.C. He has many stories to tell on that topic.

52) Brenda Duncan, Haisla First Nation, Kitimat, B.C.: executivedir@uniserve.com
- Brenda heads up the Nanakila Institute which protects the environment in Haisla Traditional Territory. She can tell you about the impacts of pollution from Alcan, Eurocan and Methanex on the health of her people

53) Sheila Watt-Cloutier, Famous Inuit Leader and Environmental Activist: iccan@baffin.ca
- Sheila is a very famous Inuit leader and environmental activist who can tell you all about what the mercury, dioxin and PCB's from Southern industry has done to the health of Aboriginal people of the Circumpolar Region

54) Ramsey Hart, Mining Watch Canada: ramsey@miningwatch.ca
- Ramsey heads up Mining Watch Canada which is a collaberation of environmental NGO's, First Nations organizations and labour groups. He can tell you lots about the impacts of mining and smelting impacts on the health and well being of aboriginal communities all over Canada.

55) Jamie Kneen, Mining Watch, Canada: jamie@miningwatch.ca
- Jamie is an aboriginal rights/environmental justice activist from way back! He is a treasure trove of knowledge and contacts on pollution impacts in Aboriginal communities.

Link to full text of New Study: http://www.cmaj.ca/cgi/rapidpdf/cmaj.090846v1
Link to Article on Gestational Diabetes and Pesticide Exposure: http://www.environmentalhealthnews.org/newscience/2007/2007-0706saldanaetal.html

Link to Full Text of Gestational Diabetes/Pesticide Exposure Study: http://care.diabetesjournals.org/content/30/3/529.full

Please Note: Pesticides have been found in the fish and wildmeat eaten by many First Nations communities all across Canada. That is in addition to the body burden of pesticides we all carry by simply eating a variety of store bought foods.
Aboriginal women suffer surge in diabetes
Native people, especially women, are developing the disease in their 40s – 30 years sooner than non-natives, study finds

The rate of diabetes among aboriginal women is four times that of women in the general Canadian population, a new study reveals.

Moreover, members of first nations are developing the debilitating illness by their 40s, while in the rest of society it tends to strike people in their 70s.

“Diabetes is a disease of young first-nations adults with a marked predilection for women,” said lead author Roland Dyck of the department of community health and epidemiology at the University of Saskatchewan.

“In contrast, diabetes is a disease of aging non-first-nations adults that is more common in men,” he said.

Dr. Dyck said the big difference in the age of onset has serious implications; diabetes is one of the principal causes of blindness, amputations, kidney failure and heart disease.

The study, published in the Canadian Medical Association Journal, examined trends among patients diagnosed with diabetes in Saskatchewan from 1980 to 2005. The sample included 8,275 aboriginal people and 82,306 non-aboriginals.

The data paint a troubling picture of an unrelenting diabetes epidemic in native communities that “is likely to continue increasing in the foreseeable future,” the paper notes.

Dr. Dyck and his team found that in 2005, 20 per cent of women and 16 per cent of men living in native communities had Type 2 diabetes. That was up sharply from 9.5 per cent and 4.9 per cent respectively in 1980.

Rates of diabetes in the non-aboriginal population rose to 5.5 per cent from 2 per cent in women over the same period, and to 6.2 per cent from 2 per cent in men.

Over all, the incidence (the frequency of development of diabetes in a population over a given time period) and the prevalence (the number of people currently suffering from the disease) were both about four times higher among aboriginal women and 2.5 times higher among aboriginal men.

The epidemiological study was not designed to explain the underlying causes of this disparity, but Dr. Dyck put forth a couple of likely explanations.

First, it has been well documented that rates of overweight and obesity are significantly higher in native communities. (Excess weight, particularly in the abdominal area, is a key factor in Type 2 diabetes.) In aboriginal communities, women are more likely to be overweight or obese than men, and at a younger age.

Second, there are high rates of gestational diabetes in pregnant aboriginal women. Those who develop diabetes during pregnancy are at high risk of developing Type 2 diabetes later in life, and so are their children.

“Gestational diabetes has been implicated in the intergenerational ‘vicious cycle’ by increasing diabetes among the offspring,” Dr. Dyck said.

He added that the differences in the epidemiology of the disease in native and non-native people means prevention programs should be different as well.

In particular, programs for first nations should focus on women in their reproductive years and on preventing gestational diabetes, Dr. Dyck said.

There are three distinct forms of diabetes: Gestational diabetes is a temporary condition that occurs during pregnancy; Type 1 diabetes, usually diagnosed in children, occurs when the pancreas is unable to produce insulin; Type 2 diabetes occurs when the pancreas does not produce enough insulin, or the body does not effectively use the insulin it produces.

About 90 per cent of diabetics have Type 2 disease, which is usually a consequence of obesity, inactivity, poor diet and aging. Poverty is also strongly associated with diabetes, which could be another factor that helps explain high rates in native communities.

The discovery, in the new scientific study described below, is very significant regarding the relationship between exposure to persistent organic pollutants and the onset of insulin resistance related diseases like Type II Diabetes. You can view the full text of this important study at this Link:

http://ehp.niehs.nih.gov/members/2009/0901321/0901321.pdf
All the best to you.

For Land and Life,
John H.W. Hummel
Pollution/Health Researcher
Nelson, B.C.
Canada

NatalieMaynor/flickr
Male rats fed fish oil from farmed salmon developed insulin resistance, obesity and related health issues.
A new study in rats shows that persistent organic pollutants (POPs) – at levels found in food – cause insulin resistance and associated obesity and liver disease in the animals. The study is the first to show this experimentally. Insulin resistance can lead to type 2 diabetes, which is becoming a global epidemic. The association between high levels of POPs in people and increased chance of developing diabetes has been known since 2006. Until now, scientists could not positively conclude that POPs influenced the onset of diabetes.

Context
Persistent organic pollutants (POPs) are a diverse group of toxic chemicals that resist degradation and can remain in the environment for decades. The compounds are known to adversely affect health in people and wildlife.

POPs include organochlorine pesticides, polychlorinated biphenyls (PCBs), dioxins and furans. Many of the synthetic chemicals were created for use in agriculture and construction. Others were used in, or are byproducts of, industry. Some – such as dioxins – also occur naturally as a result of burning and combustion.

The US and Europe banned the production and use of certain POPs more than 30 years ago. This ban was expanded globally during this century. Yet, due to their chemical nature, they can remain intact, persist in the environment and accumulate in wildlife and people. They build up in farmland soils and waterways, contaminating wildlife and making their way up the food chain. People are exposed through eating contaminated fish, poultry, meat and dairy products.

The hormone insulin helps in the uptake and storage of the sugar glucose – a basic regulator of metabolism. Insulin resistence occurs when cells do not respond to the hormone. This allows glucose levels to build up in the blood and leads to more serious health problems. Additionally, insulin and the uptake of glucose regulate the formation of fat.

In the U.S., one out of four adults have metabolic abnormalities that are associated with insulin resistance. Typical symptoms of insulin resistance are fatigue, obesity, accumulation of fat around the belly and difficulty regulating the blood levels of fat and sugar. Insulin resistance is the underlying cause of type 2 diabetes, cardiovascular problems and liver disease.

These drastic increases in metabolic disorders cannot be totally explained by current known risk factors – high fat diets and lack of exercise. Based on animal and human research findings, some scientists suspect that POPs have the potential to contribute to the diabetes epidemic that threatens people around the globe. Human studies have found associations between an increased chance of developing type 2 diabetes and higher levels of POPs in the body (Lee et al. 2006). Animal research has pointed in the same direction.
What did they do?
Adult male rats were fed for 28 days either crude or refined fish oil obtained from farmed Atlantic salmon carcasses.

The crude fish oil contained the levels of POPs that people are typically exposed to after eating the fish. The refined fish oil contained no POPs and was fed to the control rats. The levels of fat in both diets were the same.

After exposure, the researchers measured body weight, whole-body insulin sensitivity and levels of POPs in each group. They compared the levels of fat, triacylglycerol, diacylglycerol and cholesterol in the rat livers.

They also determined how well rats could regulate sugars and fats and measured the expression of several key genes that are thought to be involved in the metabolic process.

In a parallel study, fat cells were exposed to the types of POPs that were stored in the fish fat cells at similar levels found in the salmon oil. The effects on sugar uptake by the cells were measured.

What did they find?
Adult rats exposed to the crude fish oil – which contained the POPs mixture – put on belly fat and developed insulin resistance and liver disease. The rats could not regulate fat properly. They had higher levels of cholesterol and the fatty acids triacylglycerol and diacylglycerol in their livers.

In contrast, none of these changes were seen in the rats that ate fish oil without the POPs.

Although blood levels of insulin and sugar were similar among rats with either diet, the rats exposed to POPs had impaired insulin action. The POPs also altered the expression of number of genes involved in metabolism, which could explain the changes in fat and sugar regulation.

Similar results on insulin and gene expression were seen in the cultured fat cells that were exposed to a POPs mixture similar to that found in the fish oil. The POPs – especially the organochlorine pesticides – drastically inhibited insulin's action and the cells' ability to take up glucose, a first step in insulin resistence.The cells expressed fewer of the genes that regulate fat and sugar levels.

Further analysis showed the liver and fat tissue differed in the components they predominantly store. PCBs and organochlorine pesticides were measured in both liver and fat tissue while certain types of dioxins and furans were more abundant in the liver.

What does it mean?
Based on this study, daily exposure to POPs mixtures in food at levels found naturally in the environment leads to insulin resistance and an impaired ability to metabolize fat and sugar in adult male rats. The levels measured in the rats' fat tissues were relevant to humans, as they were similar to those previously reported for middle-aged Europeans.

This rodent study is the first to find that POPs can cause abnormal insulin action and adds an important missing piece to the growing body of human research that has found associations between POPs levels and insulin resistance that could cause such serious health problems as type 2 diabetes, obesity and liver disease.

Generally, animal studies provide a way to ask and answer health-related questions that cannot be studied directly in people. Humans and rats share similar hormones that work in the same general way to guide metabolism and reproduction. Because of these similarities, rats and mice are used to assess both potential drug therapies and potential effects from environmental toxicants. Results from animal studies supply insights into what might be occurring with respect to health and disease in people.

Animals and people accumulate these long-lived compounds from food and store them in fat. Most of us carry at least some types of the chemicals in our bodies. The authors say their results indicate that POPs – as with some other indicted environmental chemicals found in air pollution and plastics – "provide additional evidence that global environmental pollution contributes to the epidemic of insulin resistance-associated metabolic diseases."

The World Health Organization estimates that more than 300 million people will die from disease associated with insulin resistance and metabolic disorders by 2015. The current strategies for prevention include limiting dietary intake and increasing physical activity. This study suggests that considering the role of POPs may be warranted in prevention strategies.

Current methods of risk assessment may also fall short in protecting health, since different types of POPs mixtures impaired insulin action differently. Some did, while others did not. The dioxin and dioxin-like PCB levels that changed insulin action did not fall within the standard measure of toxicity – called the total toxic equivalent (TEQ) concentration – that is currently used to regulate safe exposures to environmental chemicals. The findings "demonstrate that risk assessment based on TEQ assigned to dioxins and dioxins-like PCBs" does not include the risk of insulin resistance, according to the study's authors.

POPs production and use are regulated worldwide. For example, in the U.S., regulations imposed by the Environmental Protection Agency have significantly reduced the release of dioxins and furans. Globally, a number of international laws limit or ban their use.

The chemicals classified as POPs do not degrade easily, so even limited production will still have an additive effect over the years. Because of this, POPs will continue to impact the environment – and possibly human health – into the future.

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Resources
Insulin resistence and pre-diabetes. The National Diabetes Information Clearinghouse, The National Institute of Diabetes and Digestive and Kidney Diseases.

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13 October Dioxin tied to metabolic syndrome in Japan. A large new epidemiological study in Japan finds that even at background levels of exposure, people with higher levels of dioxin and dioxin-like PCBs are a significantly greater risk to metabolic syndrome, which includes high blood pressure and Type 2 diabetes. Environmental Health News.

18 August In human fat tissue, Bisphenol A inhibits release of a hormone that protects people from diabetes and heart attacks. In human fat tissues, bisphenol A suppresses levels of a key hormone, adiponectin, that protects people from heart attacks and Type II diabetes. Environmental Health News.

15 April Birth Weight and Subsequent Risk of Type 2 Diabetes: A Meta-Analysis -- Harder et al. 165 (8): 849 -- American Journal of Epidemiology There is a non-monotonic relationship between birth weight and risk of Type II diabetes later in life. American Journal of Epidemiology.

6 January Increased rate of hospitalization for diabetes and residential proximity of hazardous waste sites. People living closer to hazardous waste sites containing persistent organic pollutants are more likely to be hospitalized for diabetes. Environmental Health Perspectives.

It has been suggested that exposure to radiation is a cause of diabetes. This connection should be investigated! Many indigenous people live near uranium mines. We are all exposed to releases from power plants, weapons manufacturers, and nuclear research, as well as medical use of radioactive material.

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The Dominion is a monthly paper published by an incipient network of independent journalists in Canada. It aims to provide accurate, critical coverage that is accountable to its readers and the subjects it tackles. Taking its name from Canada's official status as both a colony and a colonial force, the Dominion examines politics, culture and daily life with a view to understanding the exercise of power.